慢性膝关节炎疼痛模型的针灸治疗
发布时间：2018-08-07 16:13
【摘要】：背景:已经证实针灸对腰背痛、膝关节痛等急性疼痛等有较好疗效,但是对于慢性疼痛的效果存在争议。目的:建立新西兰兔慢性关节炎疼痛模型,探讨针灸治疗慢性关节炎疼痛机制。方法:(1)32只新西兰兔使用4%木瓜蛋白酶0.3 mL注射双后肢膝关节腔内,制成兔膝骨性关节炎模型。随机分为4组,即生理盐水+电针组,生理盐水+假电针组,k-阿片受体拮抗剂(nor-Binaltorphimine,nor-BNI)+电针组,nor-BNI+假电针组,每组8只。nor-BNI用量1 mg/kg,1次/d,连续3 d;电针干预时间为实验动物给予药物后2 h,1次/d,30 min/次,直至实验动物被处死当天结束;假电针组取穴、针刺方法及时间同电针组,但不通电刺激。使用BBB评分对各组进行下肢行为学评分。给药1,3,5,7日分别处死,分离脊髓组织后多聚甲醛固定,使用免疫荧光法检测脊髓组织白细胞介素17及白细胞介素17受体A、NR1的表达水平;(2)另取24只新西兰兔,12只兔建立膝骨性关节炎模型后随机分为模型+生理盐水组、模型+2μg白细胞介素17抗血清组;剩余12只分为对照+生理盐水组、对照+2μg白细胞介素17抗血清组。以2μg白细胞介素17抗血清溶于10μL生理盐水中进行椎管内给药,1次/d,连续3 d。使用BBB评分对新西兰兔下肢功能进行行为测试,每次行为测试后,Western-blot测定样品中p-NR1,白细胞介素17R的表达水平。结果与结论:(1)nor-BNI+电针组BBB评分明显增高(P0.05);而脊髓组织白细胞介素17及白细胞介素17受体A、NR1的表达水平明显减低(P0.05);(2)使用nor-BNI拮抗阿片类受体后,nor-BNI+电针组脊髓组织NR1的表达水平与nor-BNI+假电针组相比无明显差异(P0.05);(3)使用白细胞介素17抗血清处理后,模型+2μg白细胞介素17抗血清组BBB评分明显增高(P0.05);而该组脊髓组织白细胞介素17及NR1的表达水平明显减低(P0.05),但仍高于2个对照组(P0.05);(4)实验证实,慢性关节炎疼痛原因为白细胞介素17可以使脊髓组织NR1表达增加从而引起;电针刺激可以明显改善关节炎模型新西兰兔的下肢疼痛,这种作用是由于电针刺激减少脊髓组织白细胞介素17而非调节白细胞介素17受体A发挥作用。
[Abstract]:Background: acupuncture and moxibustion have been proved to have good effect on acute pain, such as low back pain, knee pain and so on, but the effect of chronic pain is controversial. Objective: to establish a pain model of chronic arthritis in New Zealand rabbits and to explore the mechanism of acupuncture and moxibustion in the treatment of chronic arthritis pain. Methods: (1) 32 New Zealand rabbits were injected with 0.3 mL of papain 0.3 mL into the knee joint of both hind limbs to establish a rabbit knee osteoarthritis model. They were randomly divided into 4 groups: normal saline electroacupuncture group, nor-BNI pseudoEA group. The dosage of nor-BNI was 1 mg / kg / d in each group for 3 consecutive days; the time of electroacupuncture intervention was 30 min/ after 2 h of administration of the drug, until the end of the day on which the animals were killed; the acupuncture method and time of the sham electroacupuncture group were the same as those of the electroacupuncture group. But no electrical stimulation. BBB score was used to evaluate the behavior of lower extremities in each group. 5 and 7 days after administration, the spinal cord tissue was isolated and fixed with paraformaldehyde. The expression of interleukin-17 (IL-17) and interleukin-17 receptor (A1-NR1) in spinal cord tissue were detected by immunofluorescence assay. (2) A total of 24 New Zealand rabbits and 12 rabbits were randomly divided into normal saline group after the establishment of knee osteoarthritis model. Model 2 渭 g interleukin 17 antiserum group, the remaining 12 groups were divided into control saline group and control 2 渭 g interleukin 17 antiserum group. 2 渭 g interleukin 17 antiserum was dissolved in 10 渭 L normal saline for 3 days. The lower limb function of New Zealand rabbits was tested with BBB score. After each behavioral test, the expression of p-NR1 and IL-17R in the samples was determined by Western-blot. Results and conclusion: (1) the BBB score of nor-BNI electroacupuncture group was significantly increased (P0.05), while the expression of interleukin-17 and interleukin-17 receptor Agnor-1 in spinal cord tissue was significantly decreased (P0.05); (2). Nor-BNI antagonized opioid receptor was used to antagonize NR1 in spinal cord tissue of nor-BNI electroacupuncture group (P0.05). There was no significant difference between the nor-BNI pseudoacupuncture group and the control group (P0.05); (3) after treatment with interleukin-17 antiserum. The BBB score of model 2 渭 g interleukin 17 antiserum group was significantly increased (P0.05), while the expression of interleukin 17 and NR1 in spinal cord tissue was significantly decreased (P0.05), but still higher than that in two control groups (P0.05); (4). The cause of chronic arthritis pain is that interleukin-17 can increase NR1 expression in spinal cord and electroacupuncture can significantly improve lower limb pain in rabbits with arthritis. This effect is due to the role of electroacupuncture stimulation in reducing interleukin-17 (IL-17) in spinal cord rather than regulating IL-17 receptor A (IL-17 receptor A).
【作者单位】： 西南医科大学附属医院康复医学科;西南医科大学附属医院骨与关节外科;
【基金】：四川省中医药管理局基金项目(2014-K-125) 西南医科大学青年基金项目(2014QN-107) 四川省卫计委普及应用项目(17PJ176)~~
【分类号】：R245;R-332
本文编号：2170592
[Abstract]:Background: acupuncture and moxibustion have been proved to have good effect on acute pain, such as low back pain, knee pain and so on, but the effect of chronic pain is controversial. Objective: to establish a pain model of chronic arthritis in New Zealand rabbits and to explore the mechanism of acupuncture and moxibustion in the treatment of chronic arthritis pain. Methods: (1) 32 New Zealand rabbits were injected with 0.3 mL of papain 0.3 mL into the knee joint of both hind limbs to establish a rabbit knee osteoarthritis model. They were randomly divided into 4 groups: normal saline electroacupuncture group, nor-BNI pseudoEA group. The dosage of nor-BNI was 1 mg / kg / d in each group for 3 consecutive days; the time of electroacupuncture intervention was 30 min/ after 2 h of administration of the drug, until the end of the day on which the animals were killed; the acupuncture method and time of the sham electroacupuncture group were the same as those of the electroacupuncture group. But no electrical stimulation. BBB score was used to evaluate the behavior of lower extremities in each group. 5 and 7 days after administration, the spinal cord tissue was isolated and fixed with paraformaldehyde. The expression of interleukin-17 (IL-17) and interleukin-17 receptor (A1-NR1) in spinal cord tissue were detected by immunofluorescence assay. (2) A total of 24 New Zealand rabbits and 12 rabbits were randomly divided into normal saline group after the establishment of knee osteoarthritis model. Model 2 渭 g interleukin 17 antiserum group, the remaining 12 groups were divided into control saline group and control 2 渭 g interleukin 17 antiserum group. 2 渭 g interleukin 17 antiserum was dissolved in 10 渭 L normal saline for 3 days. The lower limb function of New Zealand rabbits was tested with BBB score. After each behavioral test, the expression of p-NR1 and IL-17R in the samples was determined by Western-blot. Results and conclusion: (1) the BBB score of nor-BNI electroacupuncture group was significantly increased (P0.05), while the expression of interleukin-17 and interleukin-17 receptor Agnor-1 in spinal cord tissue was significantly decreased (P0.05); (2). Nor-BNI antagonized opioid receptor was used to antagonize NR1 in spinal cord tissue of nor-BNI electroacupuncture group (P0.05). There was no significant difference between the nor-BNI pseudoacupuncture group and the control group (P0.05); (3) after treatment with interleukin-17 antiserum. The BBB score of model 2 渭 g interleukin 17 antiserum group was significantly increased (P0.05), while the expression of interleukin 17 and NR1 in spinal cord tissue was significantly decreased (P0.05), but still higher than that in two control groups (P0.05); (4). The cause of chronic arthritis pain is that interleukin-17 can increase NR1 expression in spinal cord and electroacupuncture can significantly improve lower limb pain in rabbits with arthritis. This effect is due to the role of electroacupuncture stimulation in reducing interleukin-17 (IL-17) in spinal cord rather than regulating IL-17 receptor A (IL-17 receptor A).
【作者单位】： 西南医科大学附属医院康复医学科;西南医科大学附属医院骨与关节外科;
【基金】：四川省中医药管理局基金项目(2014-K-125) 西南医科大学青年基金项目(2014QN-107) 四川省卫计委普及应用项目(17PJ176)~~
【分类号】：R245;R-332
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